New optometry schools encounter mixed responses

The debate over the need for new U.S. optometry schools has started to heat up just as two new schools, one in San Antonio, Texas, and another in Pomona, Calif., move forward with plans to start optometry programs.

Expense is just one reason some optometrists shake their heads at the thought of another optometry school opening its doors. There are also questions about quality of applicants, perceived community needs and an oversaturated work force.

Those in favor of new schools say the profession is growing at a rapid rate, and the need for a more diverse optometric population is apparent.

Will the two schools proceed with caution, learning from a failed attempt to start a school in North Carolina? Or will they be welcomed with open arms into their respective communities?

Houston, do we have a problem?

The University of Incarnate Word (UIW), a private Catholic institute that just posted a record fall enrollment, hopes to start a new optometry program by August 2009.

Plans for the school, which would be less than 200 miles away from the University of Houston College of Optometry, have met with some concern from local optometrists.

“We’re concerned about the quality of the product and the placement of the potential graduates,” Arthur A. Medina Jr., OD, a private practitioner from San Antonio and a member of the Editorial Board of Primary Care Optometry News, said in an interview. “What we want is to have a quality program that puts out a quality optometrist who is going to practice for the next 3 or 4 decades in a changing health care delivery system.

Earl L. Smith III

“As everyone knows, most optometric state associations, and especially the Texas Optometric Association and U.S. Department of Labor, indicate that there is a growing demand for optometrists, especially because the rate of retirement is rapidly increasing,” Dr. Medina continued. “It is going to be a very daunting task and a very expensive task.”

Earl L. Smith III, OD, PhD, dean of the University of Houston College of Optometry, knows that firsthand. His school, which has 92 operatories and four outreach clinics and graduates about 90 students a year, spends about $16 million a year on operational expenses alone. That money goes toward paying faculty and staff, purchasing supplies for the clinic and educational operations, Dr. Smith said – not to mention the money it takes to buy the latest and greatest optometric devices.

“Any time there’s an advance in instrumentation, we try to make sure we have that instrumentation on hand,” Dr. Smith told PCON.

Expense was a concern also for Mario Gutierrez, OD, FAAO, a San Antonio practitioner who was opposed to the UIW optometry school at first. A small, private school education is far more expensive than a state-run program would be, Dr. Gutierrez said.

“My primary concern was that I was not sure that a small university was going to be able to produce high caliber optometrists,” he said in an interview. “I didn’t want to see these poor kids come out of school with $200,000 in debt and not be able to make good career choices. The cream of the crop would end up going to UH and, [UIW] basically, by default, would get the leftovers.”

Terry L. Dicianna, PhD, UIW provost, disagreed.

“The University of Houston has more applicants than they can accept,” he told PCON. “Currently about 75% of their students are from Texas, so Texas remains an importer of ODs. It’s our plan to help address Texas’ need.”

Mario Gutierrez

Dr. Gutierrez said speaking with Sr. Helena Monahan at UIW helped allay most of his fears.

“I feel we did our due diligence in that we had numerous meetings and conversations attempting to educate the UIW administration about the concerns and issues private practitioners have with their proposed optometry school,” he said. “It was only after our last meeting with Sister Monahan that I feel we were listened to. This is why I am now semi-neutral.

“She assured me that if they do go forward, it will be a first-rate optometry school,” Dr. Gutierrez continued. “Of course I still would prefer that it didn’t open.”

For his part, Dr. Smith said he has no problem with an optometry program opening in San Antonio. “I think we could use another school in the region,” he said. “Optometry is playing a greater role in health care and we have a growing population.”

Planning big for small towns

One of the reasons UIW officials cited for wanting to start an optometry program was that rural areas were underserved by the profession, especially those with large Hispanic populations.

“The need exists in the United States, in Texas and South Texas,” Dr. Dicianna said. “It exists especially in the area of minority ODs needed and service to a large minority population or an economically depressed local area.”

Agustin Gonzalez, OD, FAAO, who is in private practice in Dallas, said that reasoning is flawed.

“Small towns have nothing to offer most people who have a professional degree. Medical and dental fields have the same problem,” Dr. Gonzalez said in an interview. “Optometry is misusing the resources it has available.”

Dr. Gonzalez said he would prefer that a new school be put in a more rural setting such as Del Rio Laredo, but he would rather see the bilingual program at Inter American University of Puerto Rico School of Optometry expanded.

“If the IAU program was expanded, I’m sure it could supply enough [bilingual] manpower to the entire United States,” he said.

The North Carolina experience

Despite grumblings from optometrists there and a growing online opposition, the University of North Carolina (UNC) at Pembroke had lined up $10 million in funds to plan and design the state’s first optometry school.

However, that plan fell by the wayside and the funds went, instead, to another medical endeavor.

“The University of North Carolina-Pembroke is not currently moving forward with any plans to develop an optometry school,” Chancellor Allen Meadors told PCON.

Mr. Meadors said the university had several reasons for wanting to establish an optometry school there.

“We are the most racially diverse university in the South and located in a rural area,” he said. “We have throughout the South a major shortage of people of color in optometry and we have a critical and growing shortage of optometrists working in rural areas throughout the South. We felt we could have had a major impact on both of these challenges.”

Momentum was halted when UNC officials rejected plans for the optometry school. Instead, the funds went to another endeavor.

“This is not to say we will not revisit this issue at a later date, especially if the shortage of optometrists in our region continues to get worse,” Chancellor Meadors said.

School opening in California

Elizabeth Hoppe

Despite its close proximity to the Southern California College of Optometry, the Western University of Health Sciences in Pomona, Calif., is moving ahead with plans to open its own optometry school.

Elizabeth Hoppe, OD, MPH, DrPH, was just named founding dean of the program and already put in place her “academic administrative dream team” to help open the program to enrollees by August 2009.

Dr. Hoppe, who was a faculty member at SCCO for 13 years before becoming associate dean of academic affairs at the New England College of Optometry, said she has been surprised and heartened at the positive response she has received.

“We have no desire or intention of competing with SCCO on any level and plan to distinguish Western University College of Optometry on its own merits rather than by comparison with any of the other existing programs,” Dr. Hoppe told PCON.

Western University is creating three new colleges simultaneously: Optometry, Dental Medicine and Podiatric Medicine.

“Western University College of Optometry will differentiate itself by providing extensive integration with other health professions, a concentration on the full range of optometric rehabilitative services and early participation in patient care,” Dr. Hoppe said. “Students will have many opportunities to learn with colleagues in other health professions programs in the classroom, small group discussions, case-based learning and patient care activities.”

The college is in the process now of seeking accreditation and hopes to have an inaugural class of 50 to 70 students, Dr. Hoppe said. Plans are under way to build two new buildings for the College of Optometry and the other new colleges that will house a clinical facility and didactic and pre-clinical programs.

Dr. Hoppe said the program at Western University won’t meet the same fate as the proposed school in North Carolina for many reasons, one being that WU is a private, not-for-profit institution.

“Unlike a state-sponsored school,” she said, “it does not have to rely on legislative acts, endorsement by the governor or state budget funding for its program. This gives us more flexibility and more creativity to structure our program to meet its goals.”

For more information:

• Arthur A. Medina Jr., OD, is a member of the Editorial Board of Primary Care Optomery News. He can be reached at 1100 McCullough, San Antonio, TX 78212; (210) 225-4141; fax: (210) 229-9400; e-mail: medinaa@airmail.net.
• Earl L. Smith III, OD, PhD, is dean of the University of Houston College of Optometry, 505 J. Davis Armistead Bldg., Houston, TX 77204-2020; (703) 743-1899; fax: (713) 743-0965; e-mail: esmith@uh.edu.
• Mario Gutierrez, OD, FAAO, can be reached at Vision Source San Antonio, 5212 Broadway, San Antonio, TX 78209; (210) 829-8083; e-mail mariogut@flash.net.
• Terry L. Dicianna, PhD, is provost of the University of the Incarnate Word, 4301 Broadway, Box 305, San Antonio, TX 78209-6397; (210) 805-5898; e-mail: tdicianna@uiwtx.edu.
• Agustin Gonzalez, OD, FAAO, can be reached at 1881 Sylvan Ave., Dallas, TX 75208; (214) 742-2020; e-mail: my_eyedoc@yahoo.com.
• Allen Meadors is chancellor of the University of North Carolina-Pembroke, PO Box 1510, Pembroke, NC 28372-1510; (800) 949-8627; e-mail: acm@uncp.edu.
• Elizabeth Hoppe, OD, MPH, DrPH, is dean of the College of Optometry at Western University of Health Sciences, 309 E. Second St., Pomona, CA 91766; (909) 706-3497; fax: (909) 706-3500; e-mail: ehoppe@westernu.edu.